1 Goal: This SBIR project will build Stand Tall, a low-cost health-game product for older adults. Stand Tall will 2 use Kinect 3-D motion camera technology to interactively deliver an evidence-based exercise program that 3 improves strength and balance. The final product will be designed to be downloaded from the internet and 4 delivered on a personal computer equipped with a Microsoft Kinect camera. The product can be used in the 5 home, a senior center, YMCA, or as part of physical therapy. Significance Each year, approximately 30% of 6 adults age 65 years and older fall, and 20-30% of those falls result in serious injury. For community-dwelling 7 older adults, exercise that improves leg strength and balance is one of the most effective interventions to 8 prevent a fall. A few evidence-based exercise programs proven effective at improving strength and reducing 9 falls are available to the public. These programs use traditional (pen-and-paper, user's manual, train-the 10 trainer, etc.) delivery models. These programs are typically available at Senior Centers and YMCAs; however 11 there is much regional variability as to the availability of these programs. Traditional dissemination models 12 require significant infrastructure and resources, and have not achieved the goals of widespread availability of 13 impact. Innovation: Disruptive technologies such as 3-D motion controlled cameras can be used to create 14 smart delivery systems. These systems typically require a camera and a gaming console and computer. A 15 series of exercises can be delivered to a user, the user's performance, adherence, compliance, and progress 16 can be tracked. This smart system eliminates the need for extensive infrastructure, provides a cost effective 17 way to multiply the reach of these programs, and ensures programs are delivered with fidelity. Approach We 18 will build upon a pre-existing virtual physical therapy platform to create and validate a product that delivers a 19 series of balance and strength exercises to older adult users. Our Phase I prototype will contain a functional 20 falls risk screen based on the Centers For Disease Control's STEADI Tool and a representative group of 21 exercises from an evidence-based fall prevention programs. The exercises will demonstrate the full range of 22 movements required for the final product. All virtual screenings and exercises will first be evaluated in the 23 laboratory framework for fidelity. Exercises will then be translated for delivery by the prototype. A Natural User 24 Interface will be designed to maximize adoption by those with limited experience with technology. The 25 prototype will be pilot tested for usability and fidelity of the exercises within the user interface by a group of 26 novice older adult users. Once the screening tool and exercises have been validated via this pilot testing, and 27 acceptably usability scores achieved, the prototype will be ready for a complete build out, clinical trials, and 28 commercialization in Phase II.